Xu Yan, Zhu Lijing, Ru Tong, Wang Huanhuan, He Jian, Zhou Zhengyang, Yang Xiaofeng
1 Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, PR China.
2 Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, PR China.
Acta Radiol. 2017 Sep;58(9):1147-1154. doi: 10.1177/0284185116684677. Epub 2017 Jan 9.
Background Three-dimensional power Doppler ultrasound (3D-PDU) imaging has been widely applied to the differentiation of benign and malignant cervical lesions; however, its potential value for predicting response to chemo-radiotherapy has not been fully explored. Purpose To investigate the feasibility of 3D-PDU imaging in predicting treatment response in patients receiving concurrent chemo-radiotherapy (CCRT) for advanced cervical cancer. Material and Methods Fifty-two patients with advanced cervical cancer who received CCRT underwent 3D-PDU examinations at four timepoints: pre-therapy (baseline), 1 week and 2 weeks during, as well as immediately post CCRT. Final tumor response was determined by change in tumor size using magnetic resonance imaging (MRI). Cervical tumor volumes and vascular indices were calculated and compared with the clinical outcome. Results Of the 52 patients, 32 patients who completed all four examinations were included in the analyses: 21 were classified as complete response (CR) and 11 as partial response (PR). During the treatment, the CR group showed that 3D vascular indices (VI and VFI) significantly increased at 1 week ( P = 0.028, P = 0.017, respectively) then decreased at 2 weeks and obviously decreased at therapy completion (both P < 0.001), whereas tumors significantly decreased in volume at 2 weeks after therapy initiation ( P < 0.05). However, no significant differences in 3D vascular indices values were seen in the PR group during the treatment course (all P > 0.05). Conclusion Prospective longitudinal 3D-PDU imaging may have potentials in monitoring early therapeutic response to CCRT in patients with cervical cancer.
背景 三维能量多普勒超声（3D-PDU）成像已广泛应用于宫颈病变良恶性的鉴别；然而，其在预测放化疗反应方面的潜在价值尚未得到充分探索。目的 探讨3D-PDU成像在预测晚期宫颈癌同步放化疗（CCRT）患者治疗反应中的可行性。材料与方法 52例接受CCRT的晚期宫颈癌患者在四个时间点接受3D-PDU检查：治疗前（基线）、治疗期间的第1周和第2周以及CCRT结束后立即进行。最终肿瘤反应通过磁共振成像（MRI）测量肿瘤大小的变化来确定。计算宫颈肿瘤体积和血管指数，并与临床结果进行比较。结果 52例患者中，32例完成了所有四项检查并纳入分析：21例为完全缓解（CR），11例为部分缓解（PR）。治疗期间,CR组显示三维血管指数(VI和VFI)在第1周显著增加(P分别为0.028和0.017),在第2周下降,在治疗结束时明显下降(均P<0.001),而肿瘤体积在治疗开始后第2周显著减小(P<0.05)。然而，PR组在治疗过程中三维血管指数值无显著差异(均P>0.05)。结论 前瞻性纵向3D-PDU成像可能在监测宫颈癌患者CCRT的早期治疗反应方面具有潜力。
